Bevacizumab and Tocotrienol in Recurrent Ovarian Cancer
Primary Purpose
Ovarian Cancer Recurrent
Status
Recruiting
Phase
Phase 2
Locations
Denmark
Study Type
Interventional
Intervention
Bevacizumab
Tocotrienol
Sponsored by
About this trial
This is an interventional treatment trial for Ovarian Cancer Recurrent
Eligibility Criteria
Inclusion Criteria:
- Histologically confirmed epithelial ovarian cancer, primary fallopian or primary peritoneal cancer.
- Platinum resistant epithelial ovarian cancer treated with at least two different previous chemotherapeutic regimens
- Progression on previous treatment. Previous treatment with bevacizumab is allowed.
- Measurable disease by the RECIST 1.1 criteria or evaluable by the GCIG CA-125 criteria.
- Age ≥ 18 years.
- Performance status 0-2.
Adequate bone marrow function, liver function, and renal function (within 7 days prior to inclusion):
- WBC ≥ 3.0 x 10^9/l or neutrophils (ANC) ≥ 1.5 x 10^9/l
- Platelet count ≥ 100 x 10^9/l
- Hemoglobin ≥ 6 mmol/l
- Serum bilirubin < 2.0 x ULN
- Serum transaminase ≤ 2.5 x ULN
- Serum creatinine ≤ 1.5 ULN
- Urine dipstick for protein < 2+. If the dipstick shows protein ≥ 2+, 24 hour urine testing must be performed and show protein contents < 1 g.
- Written informed consent
Exclusion Criteria:
- Other malignant disease within 3 years prior to inclusion in the study, except curatively treated basal cell or squamous cell carcinoma of the skin.
- Other experimental therapy or participation in another clinical trial within 28 days prior to treatment initiation.
- Intestinal infiltration or infiltration in major blood vessels at the discretion of the treating physician.
- Underlying medical disease not adequately treated (diabetes, cardiac disease).
- Uncontrolled hypertension (BP > 150/100 despite antihypertensive treatment).
- Surgery including open biopsy, within 4 weeks prior to first dose of bevacizumab.
- Cerebral vascular attack, transient ischemic attack or subarachnoid hemorrhage within 6 months before start of treatment.
Clinical significant cardiovascular disease, including:
- Myocardial infarction or unstable angina within 6 months before start of treatment
- New York Heart Association (NYHA) class ≥ 2
- Poorly controlled cardiac arrhythmia despite medication
- Peripheral vascular disease grade ≥ 3
- Allergy to active substance or any of the auxiliary agents
- Bleeding tumor
- Pregnant or breast-feeding patients. For fertile women a negative pregnancy test at screening is mandatory.
- Fertile patients not willing to use effective methods of contraception during treatment and for 6 months after the end of treatment.
Sites / Locations
- Department of Oncology, Vejle HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Arm A: Discontinue treatment after first treatment cycle
Arm B: Continue treatment until progression
Arm Description
Outcomes
Primary Outcome Measures
Progression free survival
Secondary Outcome Measures
Overall survival
Response rate as measured by RECIST 1.1 or CA-125
Safety as measured by CTC version 5.0
CTC = National Cancer Institute's Common Toxicity Criteria (NCI-CTC)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04175470
Brief Title
Bevacizumab and Tocotrienol in Recurrent Ovarian Cancer
Official Title
Bevacizumab and Tocotrienol in Recurrent Ovarian Cancer: A Marker Based Phase II Trial
Study Type
Interventional
2. Study Status
Record Verification Date
May 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 29, 2019 (Actual)
Primary Completion Date
May 2024 (Anticipated)
Study Completion Date
December 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Vejle Hospital
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
A recent study at the Department of Oncology, Vejle Hospital (NCT02399592), investigated bevacizumab and tocotrienol in ovarian cancer patients and concurrently monitored the level of methylated HOXA9 circulating tumor DNA (HOXA9 meth-ctDNA) in the blood.
The rate of disease control was 70% with better results than other studies using bevacizumab alone. The toxicity was very low and attributed to bevacizumab only.
When the study results were worked up they showed that patients with a significant increase of HOXA9 meth-ctDNA after the first cycle of treatment did not benefit from the treatment whereas those with stable or decreasing HOXA9 meth-ctDNA did.
Therefore, in the current study patients with a high increase of HOXA9 meth-ctDNA after the first treatment cycle will discontinue treatment, as it is then considered ineffective. The remaining patients may achieve prolonged survival as predicted by their level of HOXA9 meth-ctDNA.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ovarian Cancer Recurrent
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
60 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Arm A: Discontinue treatment after first treatment cycle
Arm Type
Experimental
Arm Title
Arm B: Continue treatment until progression
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Bevacizumab
Intervention Description
10 mg/kg intravenously every three weeks
Intervention Type
Dietary Supplement
Intervention Name(s)
Tocotrienol
Intervention Description
Capsules, 300 mg orally three times daily
Primary Outcome Measure Information:
Title
Progression free survival
Time Frame
6 months after enrollment of the last patient
Secondary Outcome Measure Information:
Title
Overall survival
Time Frame
12 months after enrollment of the last patient
Title
Response rate as measured by RECIST 1.1 or CA-125
Time Frame
6 months after enrollment of the last patient
Title
Safety as measured by CTC version 5.0
Description
CTC = National Cancer Institute's Common Toxicity Criteria (NCI-CTC)
Time Frame
Every 9 weeks until progression, up to 3 years
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically confirmed epithelial ovarian cancer, primary fallopian or primary peritoneal cancer.
Platinum resistant epithelial ovarian cancer treated with at least two different previous chemotherapeutic regimens
Progression on previous treatment. Previous treatment with bevacizumab is allowed.
Measurable disease by the RECIST 1.1 criteria or evaluable by the GCIG CA-125 criteria.
Age ≥ 18 years.
Performance status 0-2.
Adequate bone marrow function, liver function, and renal function (within 7 days prior to inclusion):
WBC ≥ 3.0 x 10^9/l or neutrophils (ANC) ≥ 1.5 x 10^9/l
Platelet count ≥ 100 x 10^9/l
Hemoglobin ≥ 6 mmol/l
Serum bilirubin < 2.0 x ULN
Serum transaminase ≤ 2.5 x ULN
Serum creatinine ≤ 1.5 ULN
Urine dipstick for protein < 2+. If the dipstick shows protein ≥ 2+, 24 hour urine testing must be performed and show protein contents < 1 g.
Written informed consent
Exclusion Criteria:
Other malignant disease within 3 years prior to inclusion in the study, except curatively treated basal cell or squamous cell carcinoma of the skin.
Other experimental therapy or participation in another clinical trial within 28 days prior to treatment initiation.
Intestinal infiltration or infiltration in major blood vessels at the discretion of the treating physician.
Underlying medical disease not adequately treated (diabetes, cardiac disease).
Uncontrolled hypertension (BP > 150/100 despite antihypertensive treatment).
Surgery including open biopsy, within 4 weeks prior to first dose of bevacizumab.
Cerebral vascular attack, transient ischemic attack or subarachnoid hemorrhage within 6 months before start of treatment.
Clinical significant cardiovascular disease, including:
Myocardial infarction or unstable angina within 6 months before start of treatment
New York Heart Association (NYHA) class ≥ 2
Poorly controlled cardiac arrhythmia despite medication
Peripheral vascular disease grade ≥ 3
Allergy to active substance or any of the auxiliary agents
Bleeding tumor
Pregnant or breast-feeding patients. For fertile women a negative pregnancy test at screening is mandatory.
Fertile patients not willing to use effective methods of contraception during treatment and for 6 months after the end of treatment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Louise Faaborg, MD
Phone
+45 7940 5446
Email
louise.faaborg.larsen@rsyd.dk
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Torben F Hansen, MD, DMSc
Organizational Affiliation
Department of Oncology, Vejle Hospital - University Hospital of Southern Denmark
Official's Role
Study Chair
Facility Information:
Facility Name
Department of Oncology, Vejle Hospital
City
Vejle
ZIP/Postal Code
7100
Country
Denmark
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Louise Faaborg, MD
Email
louise.faaborg.larsen@rsyd.dk
12. IPD Sharing Statement
Learn more about this trial
Bevacizumab and Tocotrienol in Recurrent Ovarian Cancer
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